Left Ventricular Aneurysm Presenting as a Late Complication of Childhood Chemotherapy.

Thyagarajan B, Munshi LB, Amor MM - Case Rep Cardiol (2015)

Bottom Line:
Cardiotoxicity is a well known adverse effect of chemotherapy.Multiple cardiac injuries have been reported including cardiomyopathy, pericarditis, myocarditis, angina, arrhythmias, and myocardial infarction.We present a case of a young Caucasian male with a past medical history of Acute Lymphocytic Leukemia status after chemotherapy during his childhood diagnosed with left ventricular aneurysm several years later.

ABSTRACTCardiotoxicity is a well known adverse effect of chemotherapy. Multiple cardiac injuries have been reported including cardiomyopathy, pericarditis, myocarditis, angina, arrhythmias, and myocardial infarction. A left ventricular aneurysm due to chemotherapy is a rare and a dangerous complication which is particularly challenging in diagnosis requiring a high index of suspicion and periodic imaging. We present a case of a young Caucasian male with a past medical history of Acute Lymphocytic Leukemia status after chemotherapy during his childhood diagnosed with left ventricular aneurysm several years later.

fig2: Left ventriculography with contrast showing left ventricular aneurysm.

Mentions:
Eventually the patient got stabilized and was extubated. He had an echocardiogram which showed a LVEF of 36.9%, large basal and mid inferior aneurysm, akinesis of the inferior and inferolateral wall, moderate global hypokinesis of the left ventricle, and trace mitral regurgitation. He had a left and right cardiac catheterization along with left ventriculography (Figures 2, 3, and 4) which showed no evidence of disease in his left main, left anterior descending, and right coronary artery and left circumflex. His left ventriculography showed a normal sized ventricle, LVEF of 35 to 40%, and a large inferior wall aneurysm with the inferior base and midportion being akinetic. After the cardiac catheterization, the patient was transferred to a tertiary medical center for further care and he eventually received an Implantable Cardioverter Defibrillator with no surgical intervention and was managed medically with beta blocker and ACE inhibitor. Six months later after this event, the patient has been doing well with no further episodes of arrhythmias and has improved EF.

fig2: Left ventriculography with contrast showing left ventricular aneurysm.

Mentions:
Eventually the patient got stabilized and was extubated. He had an echocardiogram which showed a LVEF of 36.9%, large basal and mid inferior aneurysm, akinesis of the inferior and inferolateral wall, moderate global hypokinesis of the left ventricle, and trace mitral regurgitation. He had a left and right cardiac catheterization along with left ventriculography (Figures 2, 3, and 4) which showed no evidence of disease in his left main, left anterior descending, and right coronary artery and left circumflex. His left ventriculography showed a normal sized ventricle, LVEF of 35 to 40%, and a large inferior wall aneurysm with the inferior base and midportion being akinetic. After the cardiac catheterization, the patient was transferred to a tertiary medical center for further care and he eventually received an Implantable Cardioverter Defibrillator with no surgical intervention and was managed medically with beta blocker and ACE inhibitor. Six months later after this event, the patient has been doing well with no further episodes of arrhythmias and has improved EF.

Bottom Line:
Cardiotoxicity is a well known adverse effect of chemotherapy.Multiple cardiac injuries have been reported including cardiomyopathy, pericarditis, myocarditis, angina, arrhythmias, and myocardial infarction.We present a case of a young Caucasian male with a past medical history of Acute Lymphocytic Leukemia status after chemotherapy during his childhood diagnosed with left ventricular aneurysm several years later.

ABSTRACTCardiotoxicity is a well known adverse effect of chemotherapy. Multiple cardiac injuries have been reported including cardiomyopathy, pericarditis, myocarditis, angina, arrhythmias, and myocardial infarction. A left ventricular aneurysm due to chemotherapy is a rare and a dangerous complication which is particularly challenging in diagnosis requiring a high index of suspicion and periodic imaging. We present a case of a young Caucasian male with a past medical history of Acute Lymphocytic Leukemia status after chemotherapy during his childhood diagnosed with left ventricular aneurysm several years later.